Do Pre-Existing Conditions Affect Workmens Comp?

by Holly R Brady on November 1, 2013

Workers compensation is a good program when all factors apply appropriately. However, there are cases that are problematic when the injury victim has also filed a previous claim concerning the same body part or type of injury. Back injuries are an excellent example of how a preexisting injury can impact a case, as the back is the primary body component that experiences the most stress during physical labor.

Workers compensation rules differ across state regulations and rules can change, but Michigan has recently updated state legislation concerning filing a claim and preexisting injuries are the primary target of regulation adjustments.

How Workers Compensation Works

Anyone injured on the job has the right to file a workers compensation injury claim. It is important to understand that there will be two respondents in the claim process, those being the employer and the insurance provider. Either litigant can deny a claim for any reason.

The court will then determine the legal application of the reasoning associated with the claim denial and rule accordingly. The injured party files the injury report and then must wait seven days to see if the injury qualifies for insurance coverage. If the worker cannot return to work after seven days, then the case is retroactive to the date of the injury.

Workers compensation covers only medical bills and lost wages in return for the injured party’s inability to file a civil tort personal injury case for work-related injuries under normal circumstances. This rule changes when employers or insurers deny an injury claim.

Preexisting Injury Claims

The only time preexisting injury claims are relevant is when a permanent disability award has been paid on a prior similar injury in a claim. In most states, and clearly in Michigan, any amount paid out in prior permanent disability claim referencing the same injured body part will be deducted by the amount of the prior settlement.

In the state of Michigan, most employers are required by the state to provide worker’s comp insurance for their employees. One Michigan workmans comp law firm states “This insurance is designed to help people who have become injured or ill at work or who have had some form of a pre-existing condition aggravated while at work.”

Claims on permanently disability rulings are regularly settled in lump sums, as injured victims often take the permanent disability award amount because it is greater. Subsequent claims on a similar injury are deductible.

The Workers Compensation Agency

Workers compensation claims in Michigan are adjudicated by the Workers Compensation Agency in order to address needs of injured workers in a timely manner. This also means that the process is largely one of paperwork when a claim begins. The agency is largely an administration agency that diverts contested claims into the WCA administrative court system.

Although the process is well-designed on the agency website and a denied injured claimant may be able to navigate, it is always important to retain an experienced legal counselor to ensure that all information is provided according to agency requirement, and no possible denial errors are included on any claimant forms.

It is important to understand that injured workers are filing a claim against two litigants in a workers compensation claim. The employer may react to the injury in good faith and file the proper injury reports to begin insurance protection, only to have the insurance provider deny the claim. Conversely, employers can refuse to file the injury paper work, especially if they have knowledge of a prior similar injury.

Refusing a workers compensation claim based on a prior injury without a permanent disability document can be considered bad faith bargaining for both the employer and the insurance provider, which could also result in additional punitive litigation claims. Whether it is a Florida or Michigan workmans comp law firm, it is imperative to seek out legal counsel within the state you live. Do not think that a prior injury will necessarily exclude a settlement on an immediate work-related injury.

Holly R Brady

Holly R Brady

Holly R. Brady first began blogging while studying for her psychology degree and enjoys writing on legal and lifestyle topics. When she isn’t writing she likes swimming and reading, as well as taking long walks with her two Irish Setters.
Holly R Brady

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